Organization
IDAHO STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY L. BISHOP M.S. (AUDIOLOGIST)
(208) 282-3495
Entity
Organization
Contact information
Practice address
650 MEMORIAL DRIVE, # 68, POCATELLO, ID 83209-0001
(208) 282-3495
(208) 282-4571
Mailing address
650 MEMORIAL DRIVE, # 68, POCATELLO, ID 83209-0001
(208) 282-3495
(208) 282-4571
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD1225
ID
Other
Enumeration date
06/18/2006
Last updated
08/22/2020
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